Neurodevelopmental Outcomes of Preterm Infants Born <29 weeks with Bronchopulmonary Dysplasia Associated Pulmonary Hypertension: A Multicenter Study

Objective: To determine neurodevelopmental outcomes of preterm infants born at < 29 weeks gestational age (GA) with bronchopulmonary dysplasia and pulmonary hypertension (BPD-PH) at 18 to 24 months corrected age (CA). Methods: In this retrospective cohort study, preterm infants born at < 29 weeks GA between January 2016 and December 2019, admitted to level 3 Neonatal Intensive Care Units, who developed BPD and were evaluated at 18-24 months CA in the neonatal follow-up clinics were included. We compared demographic characteristics and neurodevelopmental-outcomes between the two groups: Group I: BPD with PH and Group II: BPD without PH, using univariate and multivariate regression models. The primary outcome was a composite of death or neurodevelopmental impairment (NDI). NDI was defined as any Bayley-III score < 85 on one or more of the cognitive, motor, or language composite scores. Results: Of 366 eligible infants, 116 (Group I [BPD-PH] =7, Group II [BPD with no PH] =109) were lost to follow-up. Of the remaining 250 infants, 51 in Group I and 199 in Group II were followed at 18-24 months CA. Group I and Group II had median (IQR) birth weights of 705 g (325) and 815g (317) [p=0.003] and median gestational ages (IQR) were 25 weeks (2) and 26 weeks (2) [p=0.015], respectively. Infants in the BPD-PH group (Group I) were more likely to have mortality or NDI (adjusted Odds Ratio [aOR] 3.82; bootstrap 95% CI; 1.44-40.87). Conclusion: BPD-PH in infants born at < 29 weeks GA is associated with increased odds of the composite outcome of death or NDI at 18-24 months CA.